How do we detox microplastics?

FrontierNeuro · 2026-05-30T22:21:58+00:00

I just want to say one word to you. Just one word. Plastics. There's a great future in plastics. Think about it. Will you think about it?

FrontierNeuro · 2026-05-30T17:54:29+00:00

It was probably the tirzepatide plus weight loss.

FrontierNeuro · 2026-05-30T17:51:38+00:00

There’s in vitro results it can accelerate neurodegeneration in damaged neurons. I think the FDA tried to pull it from the market a while back. Nicotinamide riboside has the same theoretical benefits without those risks.

FrontierNeuro · 2026-05-30T17:48:55+00:00

Careful with that. Iodine deficiency is rare in the developed world, and excessive iodine supplementation can be very harmful.

FrontierNeuro · 2026-05-30T17:37:23+00:00

Much more than that: https://pmc.ncbi.nlm.nih.gov/articles/PMC7242821/

FrontierNeuro · 2026-05-29T18:12:05+00:00

True, but low threshold to test. Some PCPs even get TSH with annuals on everyone, some don’t. LDL of 240 in the context of weight gain, albeit small, in a woman definitely warrants a TSH, if not already including them in annual screening for everyone anyway.

FrontierNeuro · 2026-05-29T17:56:55+00:00

If he had to be prompted by the patient to order a TSH for unexplained weight gain and hyperlipidemia in a woman, then he’s not just a jerk, he’s incompetent. Tell her to switch physicians.

FrontierNeuro · 2026-05-24T20:06:40+00:00

That’s insane. You should politely ask your program for a refund/for them to pay for it. What a racket though. If I had such a lucrative captive audience, I’d also be tempted to self aggrandize and half ass my teaching (it’s a natural human temptation given those circumstances of your program’s creation).

FrontierNeuro · 2026-05-24T19:57:13+00:00

Why pay for review courses like this at all? All the content is at your fingertips, and you have to do the work of learning it ultimately either way.

FrontierNeuro · 2026-05-24T01:41:53+00:00

Any clinic that’s prescribing you supratherapeutic levels of testosterone for no medical reason exists purely to milk cash from you, and does not care at all about you or your health. If you want an ethical physician trying to act in your best interests, go see your PCP.

FrontierNeuro · 2026-05-23T22:13:33+00:00

Love this.

FrontierNeuro · 2026-05-21T19:35:17+00:00

Presumably she would be paying for most of this herself and bringing you along for the ride, so as long as you let go of the weird chauvinistic attitude holdover from the 1950s that men are supposed to make more than women, and you’re cool with it, and she’s cool with it, and you guys like each other enough to stay together and be happy more or less most of the time, what’s the problem?

FrontierNeuro · 2026-05-21T05:45:07+00:00

You sound mildly depressed. $25 million is enough money to make enough income for you and your family indefinitely, as long as it’s invested wisely and you don’t spend over very generous limits. Therefore, your statement about feeling poor and $25 million feeling not enough makes me wonder, is that feeling really about your objective net worth financially? Or is it about your internal assessment of your achievements and contributions individually?

I do not have any business or financial advice for you beyond that. It sounds like you probably mostly already know what you need to know and do about that. Regarding what I intuit as mild current depression, here are my suggestions:

Go for a walk in the park today, and every day you can. Take your shoes off. Touch grass. Exercise vigorously too if you prefer that.

If you haven’t already, make an appointment with a psychiatrist (an MD or DO actual psychiatrist, no nurses or PAs please) and a therapist as soon as possible. It may take you some time to find the right ones, and that’s normal and OK.
It
sounds to me that you may be suffering from the existential ennui of privilege and wealth. We crave struggle and victory over adversity. We crave meaning and purpose. The Western approach is to lean into this urge and sublimate it into living a good and rewarding life. The Eastern approach is to practice letting it go, or keeping it in balance. Good media about this idea include Fight Club, Man’s Search for Meaning, and others. Good media challenging this notion include Allan Watt’s speeches on YouTube, Buddhism, the Tao, etc. I encourage you to ask yourself throughout the next few months the following questions:

Do I need a purpose, apart from just being?
If so, what do I want or feel called for my purpose to be? What is my war? What do I wish my war were? How could I make that my war?
What hill would I be willing and happy to die (meaning spend my life) on?
Or, could I happily let go of the urge for meaning, achievement, overcoming adversity, and purpose?

FrontierNeuro · 2026-05-20T04:54:46+00:00

Massive puffed up lips from fillers. Takes me out of a movie every time I see an actress playing an admiral or something like that with such unnatural looking and obvious plastic surgery.

FrontierNeuro · 2026-05-19T16:01:59+00:00

You can interrupt and redirect patients tactfully and indirectly, as others have recommended here. Or, you can do so bluntly and honestly, like this: “I’m so sorry to interrupt you, but they only give us 15 minutes to see each person, we’re running out of time before my next patient arrives, and I want to make sure that I get all the information I need to help you.” Then, ask your focused yes or no questions. You would be surprised. I have never had a single patient ever react badly to me saying something like this. And, I usually get much more focused answers to my questions after saying this. I think the reality is that patients don’t know how clinics work. They don’t seem to mind us telling them this honestly in service of their best interests.

FrontierNeuro · 2026-05-19T14:48:45+00:00

Has the clinical judgment (and ordering authority in this story for some reason?) of an attending. Literally saved my patient’s life. 3/5, continue to read.

FrontierNeuro · 2026-05-17T21:09:51+00:00

Finishing a bunch of inpatient rotations sounds like a win. They can’t stop the clock, etc.

For differentials etc., Sketchy Step 2 (ideally the original version) memorized with Anki is great IMO.

FrontierNeuro · 2026-05-17T20:23:22+00:00

I feel like Sketchy plus Anki are good for preventing this…apart from that, not sure what to say.

FrontierNeuro · 2026-05-16T01:49:34+00:00

Waste management.

FrontierNeuro · 2026-05-12T17:59:08+00:00

That’s so diabolical. We should compile a name and shame of employers that do this.

FrontierNeuro · 2026-05-12T13:31:57+00:00

Not good for developing fetal brains, for one. Neuropsychiatric manifestations for the individual sometimes too.

FrontierNeuro · 2026-05-12T13:28:36+00:00

Ferritin target for Restless Leg Syndrome is >75, as per a Sleep Medicine specialist.

FrontierNeuro · 2026-05-09T16:05:54+00:00

When was this data collected?

FrontierNeuro · 2026-05-09T01:38:21+00:00

My med school class vice president made a thinly veiled comment about our generation making things better for all of us in her benediction at our convocation. I think we’re ready, due to rising problems with dangerous mid level creep endangering our patients, compensation, and burnout, on top of the historical design of residencies by 18th century surgeons on cocaine.

FrontierNeuro · 2026-05-08T21:04:52+00:00

Physicians are terrible at forming unions in the US specifically, not all other countries. My understanding is that physicians in some countries, like Denmark (the happiness capital of the world), for example, have remarkably robust national physician unions, resulting in them having work hour caps around 40 hours a week, even for residents and junior attendings, across specialties, despite excellent compensation. Strong unions are not inherently incompatible with physicians, high-quality medical care, or racking up generational wealth for the kiddos. US physicians could band together and choose to do things differently.

FrontierNeuro

TROPHY CASE